title: MUNDUS project: MUltimodal neuroprosthesis for daily upper limb support.
abstract: BACKGROUND
  MUNDUS is an assistive framework for recovering direct interaction capability of severely motor impaired people based on arm reaching and hand functions. It aims at achieving personalization, modularity and maximization of the user's direct involvement in assistive systems. To this, MUNDUS exploits any residual control of the end-user and can be adapted to the level of severity or to the progression of the disease allowing the user to voluntarily interact with the environment. MUNDUS target pathologies are high-level spinal cord injury (SCI) and neurodegenerative and genetic neuromuscular diseases, such as amyotrophic lateral sclerosis, Friedreich ataxia, and multiple sclerosis (MS). The system can be alternatively driven by residual voluntary muscular activation, head/eye motion, and brain signals. MUNDUS modularly combines an antigravity lightweight and non-cumbersome exoskeleton, closed-loop controlled Neuromuscular Electrical Stimulation for arm and hand motion, and potentially a motorized hand orthosis, for grasping interactive objects.
  
  
  METHODS
  The definition of the requirements and of the interaction tasks were designed by a focus group with experts and a questionnaire with 36 potential end-users.
  
  
  RESULTS
  The functionality of all modules has been successfully demonstrated. User's intention was detected with a 100% success. Averaging all subjects and tasks, the minimum evaluation score obtained was 1.13 ± 0.99 for the release of the handle during the drinking task, whilst all the other sub-actions achieved a mean value above 1.6. All users, but one, subjectively perceived the usefulness of the assistance and could easily control the system. Donning time ranged from 6 to 65 minutes, scaled on the configuration complexity.
  
  
  CONCLUSIONS
  The MUNDUS platform provides functional assistance to daily life activities; the modules integration depends on the user's need, the functionality of the system have been demonstrated for all the possible configurations, and preliminary assessment of usability and acceptance is promising.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pedrocchi
authors.forename: Simona
authors.initials: S
authors.lastname: Ferrante
authors.forename: Emilia
authors.initials: E
authors.lastname: Ambrosini
authors.forename: Marta
authors.initials: M
authors.lastname: Gandolla
authors.forename: Claudia
authors.initials: C
authors.lastname: Casellato
authors.forename: Thomas
authors.initials: T
authors.lastname: Schauer
authors.forename: Christian
authors.initials: C
authors.lastname: Klauer
authors.forename: Javier
authors.initials: J
authors.lastname: Pascual
authors.forename: Carmen
authors.initials: C
authors.lastname: Vidaurre
authors.forename: Margit
authors.initials: M
authors.lastname: Gföhler
authors.forename: Werner
authors.initials: W
authors.lastname: Reichenfelser
authors.forename: Jakob
authors.initials: J
authors.lastname: Karner
authors.forename: Silvestro
authors.initials: S
authors.lastname: Micera
authors.forename: Andrea
authors.initials: A
authors.lastname: Crema
authors.forename: Franco
authors.initials: F
authors.lastname: Molteni
authors.forename: Mauro
authors.initials: M
authors.lastname: Rossini
authors.forename: Giovanna
authors.initials: G
authors.lastname: Palumbo
authors.forename: Eleonora
authors.initials: E
authors.lastname: Guanziroli
authors.forename: Andreas
authors.initials: A
authors.lastname: Jedlitschka
authors.forename: Marco
authors.initials: M
authors.lastname: Hack
authors.forename: Maria
authors.initials: M
authors.lastname: Bulgheroni
authors.forename: Enrico
authors.initials: E
authors.lastname: d'Amico
authors.forename: Peter
authors.initials: P
authors.lastname: Schenk
authors.forename: Sven
authors.initials: S
authors.lastname: Zwicker
authors.forename: Alexander
authors.initials: A
authors.lastname: Duschau-Wicke
authors.forename: Justinas
authors.initials: J
authors.lastname: Miseikis
authors.forename: Lina
authors.initials: L
authors.lastname: Graber
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ferrigno
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000502:physiology; D062207:Brain-Computer Interfaces; D005260:Female; D006225:Hand / Q000502:physiology; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D058117:Neural Prostheses; D009468:Neuromuscular Diseases / Q000534:rehabilitation; D011474:Prosthesis Design; D011597:Psychomotor Performance / Q000502:physiology; D013119:Spinal Cord Injuries / Q000534:rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000502:physiology*